The Happenings of GlobeMed at Vanderbilt

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Hi everyone! We’ve been back in the US for a couple days now and are slowly getting back into our daily routines. This post is way overdue, but we thought it was important that we left you with the final things that we learned that DEA is undertaking in the town of Paracas.

This town is three and a half hours south of Lima and was greatly affected by an earthquake in 2007. It is also home to one of three national reserves in Peru and has one of the most breathtaking landscapes we had the opportunity of seeing. There are two aspects to the project in Paracas: an educational, health, and environmental sustainability program similar to the one in La Tablada, and a second eco-tourism project designed to allow DEA to become more financially independent, while also allowing those less fortunate to travel to one of Peru’s most beautiful locations.

Our first stop was to see the site where the new DEA building would stand. While it was nowhere near the size of the building in Lima, it would definitely be substantial as it contained all the necessities: a clinic, a classroom, an office, garden, and multipurpose room.We were then taken to the eco-tourism project site a few minutes away. Moises, Mili’s son, is given credit for this idea of an eco-tourism package designed to give those who live in lesser off communities (i.e. southern Lima) the opportunity to visit the Paracas area for a reasonable price. As of now, DEA has four rooms, each of which can hold up to 3-4 people, and electricity, plumbing, and water from a well. A kitchen and dining area, as well as a garden, are under construction. While DEA receives an income from the recycling program in Lima, this creative initiative will allow them to become even more self-sustaining. There are also plans of expanding this recycling program in Cusco, which could further support DEA. In addition, there are communities around Cusco in need of similar La Tablada-type projects, and once DEA can assess these needs, a similar mission that can donate resources to the region will be implemented.

Learning about all these plans for the future of DEA was extremely exciting, but we also got to hear a bit about its history. Dios Es Amor originally began as an investment made by a family friend to construct a project in the area of La Tablada to help the local children. However, there were insufficient funds to finish construction, so Ignasio (Moises’ father) reached out to old friends in Germany (who had similar values and goals of helping those less fortunate) in hopes of receiving aid. Ever since then, a group of Germans has visited DEA regularly, and has seen the impact DEA has made in the community. Their continuing support through fundraising in Germany has allowed DEA’s mission and project to grow. While we are certain these German friends have the ability to raise a much larger amount of money than we can every year, every little bit helps. The connection between Globemed and DEA was made fairly recently (2010). Two volunteers that had come to help DEA from Israel knew of Globemed and saw how these two organizations could benefit from each other. And thus, Globemed began at around the same time at Vanderbilt and we were paired with Dios Es Amor! (Thank you girls from Israel!)

Most importantly, we learned what an amazing philosophy DEA has. Through simple social programs, education, environmental sustainability, and community health, this organization has the ability to empower its community members. It gives them the resources and most basic needs so that they can rise out of, and stay out of poverty. Now, there is a generation of DEA workers that were once beneficiaries (as children) in the after-school programs. We hope Dios Es Amor’s mission continues for many years to come!

While we’ve learned an incredible amount about the healthcare system and the environmental problems and initiatives taking place in Peru, we’ve also had the opportunity to explore the city of Lima itself to gain a better understanding of its history and culture.

On Thursday, we visited an exhibit called ‘Yuyanapaq’ in the Museo de la Nación del Perú, part of the Ministerio de Cultura del Perú located in the San Borja district of Lima. This term means ‘to remember’ and it honors the death of the 69,000 Peruvians who were killed in the internal armed conflict during 1980-2000. A Maost group called the Shining Path, the Túpac Amaru Revolutionary Movement, and the Peruvian government were the key players in this conflict. The exhibit did an excellent job of illustrating the complicated nature of war, showing the tragedies and atrocities committed by both the rebel groups in their uprising against the government and the Peruvian military’s hardline response that led to the imprisonment and death of many innocent citizens.

Friday, we visited the catacombs of Iglesia de San Francisco: an impressive church near the Plaza de Armas in Lima. We already had the opportunity to visit the inside of the church alongside several other areas of Central Lima during our first weekend; however, we missed out on seeing the catacombs and were glad that Mili added this memorable visit to our itinerary. Over 25,000 bodies were buried underneath the church, with layers of bones piled on top of another in wells in subterranean rooms that were many meters deep. The catacombs are not for the claustrophobic, and we both had to struggle to avoid banging our heads against the low-lying stone ceilings. Aside from the catacombs, the artwork left a lasting impression. The centuries old paintings in the church’s galleries depicted classic Catholic themes with a slightly Peruvian twist. In a stunning rendition of the Last Supper, classic local dishes such as potatoes (‘papas’) and guinea pig were front and center at the table.

On Friday night we made our way back to Barranco and went to a restaurant named La Candelaria. We had the opportunity to eat some local fried papas as well as drink a few of Peru’s famous drink named ‘pisco’. More importantly, however, we got to see a show of traditional Peruvian folklore dancing. About ten dances were shown and each was from a different region of Peru. The unique costumes, music, and overall atmosphere made for a truly special evening with our hosts. Near the end, all of the foreigners (‘extranjeros’) including us were called up to the stage and groups from every country introduced themselves and were forced to awkwardly dance to a random song that was representative of that region. Hopefully the crowd got a good laugh out of it…

That’s all for now, but a big post should be coming soon! We are currently in Paracas and have lots of exciting news to share!

The last few days have flown by, as we have learned more details about DEA’s facilities and projects, talked to more of the workers and partner organizations of DEA, and added to our growing knowledge of Peru’s culture and history.

Wednesday afternoon, we had the pleasure of meeting and introducing ourselves to several of the elderly individuals who regularly come to Dios es Amor. Many of them traveled to Lima when they were younger in hopes of finding education and healthcare; however, because they could only afford to build a home in the poor districts, they usually ended up receiving neither. Dios es Amor provides them with reading and writing classes, as well as a doctor who visits every once in a while. We were also able to witness one of their biweekly Tai Chi classes, which allow them to not only get some exercise but also be social with other older members of the community. Afterwards, we sat down with DEA social worker and media manager Alexis Martinez to participate in an interview. He was interested in our perspective on the issues of poverty, lack of education, and healthcare in southern Lima and wanted us to compare what we had seen to conditions in other countries. Between the two of us, we were able to draw comparisons to countries in Europe, China, the U.S., and Ghana. We saw similarities in the problems facing poverty-stricken areas of Lima and those of communities in Ghana and China, but noticed that the prevalence of trash in the streets of La Tablada stuck out when comparing Lima to these regions.

This theme of rising public awareness and activism in the area of environmental issues has been at the forefront of experiences this week. DEA is currently expanding the scope of its own recycling program. Through partnerships with environmental consulting companies such as ‘Go Green,’ DEA establishes relationships with local businesses that supply used materials composed of cardboard, paper, glass, metal, and recyclable plastics. Almost every day, drivers pick up these materials and deposit them in the main DEA facility for conversion into arts and crafts that can be sold for a profit or resale to larger companies specializing in the conversion of used items into new raw material. Glass bottles, for example, are collected and sold to Owens-Illinois, a company that generates 4.5 million tons of post-consumer use glass products every year. Recently, DEA has formed partnerships with large organizations such as Recíclame to expand this collection and resale program to other types of materials beyond glass. On Friday, we ran into two executives of Recíclame’s Peru branch who were participating in the Día Mundial del Medio Ambiente celebrations in downtown Lima. This holiday drew many local NGOs, companies, and municipal organizations to a square next to the Plaza de Armas. We made our way through crowds of elementary school students and employees to learn about the types of innovative solutions local schools and multinational organizations were using to tackle the issues of waste disposal and air quality. These ranged from sophisticated chemical processes that convert car oil into more usable forms to simple municipal efforts to help residents grow trees on their property.

Although most of the companies and initiatives for creating sustainable solutions for the environment have only started within the past five to ten in Peru, it was refreshing to see that there are many passionate people who are adamant about making a change and a lasting impact in their local communities.

Our trek to the top of the hill took us through many parts of the local community known as “La Tablada.”

As we began the ascent, we passed many houses that were constructed on the steep slopes of the hill. Since there are no paved roads lining the sides of this 1,000 m high hill, residents must walk long distances to reach nearby hospitals, markets, and schools.

The beginning of a long morning workout…!

We caught our breath at the top of the hill and took in an incredible view of the surrounding area.

On the left, you can see a cement factory and industrial area that is separated from the rest of La Tablada by a series of smaller hills.

This type of weather is the norm in Lima during the winter. During our trip, we saw many cloudy days with occasional periods of light drizzles.

Residents of this community must constantly come up with creative solutions to everyday problems.

…And we begin the walk down the hill. Fortunately for us, the return trip was significantly easier.

Our next stop was a local school.

Trash litters the streets of this district. In Lima, there are both public and private trash collectors but the public collection trucks are unreliable. Public collectors drive by every 10-12 days, but offer poor coverage in poverty-stricken districts that lack paved roads.

A young girl stands outside this local school during a midday break.

Parents and family members converse with one of the teachers of the school outside its gates.

Parents and students examine class photographs that were recently taken.

Across the street from the school is a bookshop, or ‘libreria,’ where students hang out during midday.

Churros and picarones, similar to donuts, are popular snack items in Peru, and you can find vendors on every street corner selling these delicious pastries.

The food was one of the highlights of the trip. Staples of Peruvian cuisine include rice, chicken, many different types of potatoes, and corn-based soup broths.

A street vendor displaying the vast assortment of fruit that she is selling. During our trip, we have had many opportunities to try many different types of fruit that are unique to Peru.

We stopped by this open-air market, where locals can buy anything ranging from fresh produce to electronics.

Inside the busy market.

This hospital that we visited is one of the 250 public and private hospitals located in Lima. As a public hospital, it belongs to the “Ministerio de Salud” and serves this difficult to reach, high altitude community. Supply shortages here are common, since bulk transportation from the city is difficult.

A picture of us and Mili in front of the public hospital we visited and brought medicine to.

Jeff holding little Jeff. This pleasant surprise was a great end to our hospital visit.

The past few days have been filled with many different activities and – through them all – we’ve learned an incredible amount about Peru, it’s inhabitants, and the problems that their communities are facing. On Tuesday, DEA workers Maria, Silvia, and Doris, took Jeff and I on a hike up the hill that overlooks the community. Maria told us about the difficulties of raising children and maintaining a healthy family life in this area, especially for parents who constantly commute and work to fight against the poverty all around them. Many local children lack positive outlets to deal with the obstacles they face outside and inside the home, which has led to a high prevalence of depression and other mental illnesses in the community. DEA has begun to tackle this issue with the hiring of a psychologist to meet with youth and adults twice a week on Tuesdays and Thursdays. Maria recounted the recent success they had with drawing therapy sessions for younger children, who were more open in sharing their problems through art than through conversation.

As for the climb, it was a workout to say the least. The hill had stairs that the ‘municipalidad’ built for the community as it is so steep. The view from the top was remarkable and shocking: it overlooked a large portion of the slums as well as the ocean. While this view was an experience for us as it isn’t something we see everyday, we had to remind ourselves that this is ‘everyday life’ for thousands, or perhaps millions, of people. Though poverty in southern Lima is a huge issue, we learned that the government is doing very little to help out. The government is channeling money into the tourist districts of Lima and several mining projects rather than investing in the areas of health and education. Many recent programs have stirred great controversy, since very little taxpayer money put into these projects has reached the hands of those in the community and has instead been funneled into the few middlemen who benefit from systemic corruption. The rest of the day was spent doing the usual: playing and teaching the kids. Moises was nice enough to take us into Barranco, a district that is artsy, bohemian, and very cultured, for dinner, drinks, and a tour.

Our Wednesday morning was full of surprises. We drove up one of the hills of the slums with a box of medicine to visit a public hospital and speak to the nurses and doctors. Although everyone receives healthcare in Peru, there is a huge difference in the quality of care received at private versus public hospitals. Only the wealthy can afford private hospitals, leaving a majority of the population to wait at understaffed public hospitals. It can often take three months to receive a checkup at a public hospital because of lack of resources, skilled workers, and funds from the government. Yovanna, a nurse at the hospital, was exasperated by constant shortages of simple yet fundamental items like gloves, surgical face masks, cotton swabs, and antibiotics. These issues gave us a new perspective on the discrepancies in health care both within the Peruvian system and between different countries such as our own. Despite these obstacles, passionate staff members are finding innovative ways to help the community. The hospital sends doctors door to door to interview families living in the high altitude area so that it can assess what health needs must be met and how they can be addressed within the confines of the system.

As we were wrapping up, Jeff received a pleasant surprise. At the beginning of our tour, we met a woman who had recently given birth and was having trouble thinking of a name for her new baby boy. Jeff was honored to learn that she had decided to name her child after him. We vowed to return with supplies and medicine next week, and perhaps we will also get a chance to see baby Jeff…

Surco – the third largest district of Lima. Home to our host Mili, many parks, and bustling open-air markets.

The “arco mosaico” towers over Surco’s “Parque de la Amistad.” This structure is a replica of a structure built to celebrate the 100th anniversary of Peruvian independence from Spain.

Peru is home to over 3,800 types of potatoes, and the “papa” holds a special place in culture and cuisine here. The day of our arrival in Surco, a large potato festival was being held in the middle of the Parque de la Amistad.

Of Peru’s forty-three districts, Villa María del Triunfo is one of the poorest in terms of income, access to health care, and infrastructure. Dios es amor’s (DEA) main facility is located on this street, which lacks paved roads.

DEA’s main courtyard at midday. Several buildings surround the courtyard and are home to the many disparate DEA operations such as their school, recycling center, small clinic, and living quarters for staff members.

Outside of DEA’s main office building is a vegetable garden used to harvest fresh produce to be made into delicious, nutritional meals. These free meals are important for the local children who frequent the facility, as many of them are malnourished.

DEA hires several doctors and a psychologist to perform checkups and simple procedures for free to local community members. In addition, medicine is prescribed and community members are educated on general healthy or any specific conditions they are facing.

This machine towers over the main room of the recycling facility. Used plastic bottles are converted into works of art such as colorful ornaments and intricate perfume bottles.

We arrived on the day of a Peruvian national holiday, “el dia nacional del reciclador.” The afternoon was filled with speeches, food, and the pictured celebration over this ceremonial cake made of recycled cans.

Margot spends some quality time with Bobby, one of the two dogs who call DEA their home.

Rex stands guard on the second floor balcony of the DEA complex.

This multipurpose field is used by local children as well as a group elderly individuals who participate in weekly Tai Chi exercises.

In the afternoon we helped local DEA children in the after-school program with homework and gave supplemental English lessons. DEA’s environment ensures that these children have access to both educational resources and safe, fun recreational activities such as this swing-set pictured above.

Luis enjoys a book in DEA’s school area. Local children are able to receive free lessons from tutors as well as complementary access to computers with high-speed internet.

When we arrived, the school area was undergoing renovation, as furniture was being rearranged while construction finished on one of the doors of the building.

Even though we were finally settled into our surroundings, it was time to pack up again and experience a new area of Lima. On Sunday afternoon, we moved into the home of our host, Mili, in the district of Surco. Mili is the administrator of Dios es Amor (DEA), a community-based organization located in a southern district of Lima that sponsors free educational, health, and sustainability initiatives. Even from our first impressions, we were able to see how dedicated, generous, and caring of an individual she is. She made us feel at home right away.

We were picked up by Moises, Mili’s son, and given an extensive tour of Surco, with its main plaza and its many parks. At one of the parks, we hiked up a steep hill that overlooked all of the surrounding area. It was remarkable to see the stark difference between the more developed northern parts of the city and the slums of the south, which seemed to run on forever. This view of the slums left a huge impression on both of us, as we knew this is where we would be headed the next day to begin work at DEA.

On Monday, we had a twenty-minute drive through southern Lima on the way to DEA. As we approached La Tablada, the town where DEA is located, piles of trash, stray dogs, unpaved roads, and chaotic traffic replaced the tranquil, green sidewalks of Surco. We finally arrived at DEA’s facility after days of anticipation and were greeted to a warm welcome by its staff members. We quickly became acquainted with the different areas of the complex: a classroom, multipurpose eating room, kitchen, small clinic, office space, garden, and a playground.

In the afternoon, DEA hosted guests from a partnering organization for a celebration of a national recycling holiday. This private company provides eco-friendly services such as carpooling and educational initiatives. We were surprised to hear that this green trend in Latin America is a relatively new phenomenon, whereas these themes have existed in the U.S. for many years.

The rest of the day was spent getting to know the local kids. After a game of tag outside on the playground that tired us out more than the kids, we headed inside to teach them English and help with homework. “Como se dice enferma en ingles?” asked Luis, and as I finished writing ‘sick’ next to its Spanish counterpart on the whiteboard, I was suddenly cut off. “Malo!” shouted Luis as the other kids giggled and pointed at the ‘i’ that I had put at the beginning of “enferma.” As we taught the kids more English vocabulary, they simultaneously helped us improve our crude Spanish skills. Any language or cultural barriers were eroded as we bonded over characters in The Avengers, Disney Channel, and Dragonball.

With another few days coming to a close, we’re excited for the plans ahead: getting tours of local hospitals, traveling to a DEA project set up in another district, and experiencing more of Lima!

One of the many, many cats that inhabit Parque Kennedy. Rumor has it that one local Lima cat lady donated her collection to the park.

Trees, colorful streets, colonial-style architecture, and towering modern apartment buildings. Lima is a city of many competing styles, tastes, and cultures.

Catholic influences dominate Peruvian culture. Many smaller churches (such as the one pictured above) litter the city’s various districts.

Speaking of architecture, many of Lima’s residential buildings have a decidedly Spanish and European taste.

Built in 1535 upon Francisco Pizarro’s orders, the Government Palace has served as the home of Peru’s government since the country’s colonial days as a viceroyalty of the Spanish empire.

“It is the finest and most well-formed [plaza] that I have ever seen, even in Spain. It occupies an entire block, with the width of four streets on one side and four streets on the other, and with all four sides it measures more than two thousand feet; it is very flat…” – 17th century historian Bernabé Cobo

Vamos a la playa! Overlooking Lima’s gorgeous coastline are a series of steep cliffs formed from many years of receding tides and rampant geological activity. On a clear day, there are surfers riding the waves and locals playing pick-up games of soccer along the beach.

El Parque de Amor lies on a cliff overlooking the beaches of Lima. Although no one here knows the origin story, it is a popular destination for many local couples and tourists.

Greetings from Peru! This is Margot and Jeff blogging our Globemed GROW trip to Lima, Peru. We’ll be here for around two weeks working with our partner organization Dios es Amor, while also traveling and experiencing the culture, food, and language.

We arrived in Lima on Friday after an eight hour flight from Newark. Right before leaving the States, we had received a last-minute update from Mili that she would be out of town for the weekend and that she booked us a hostel in the district of Miraflores. Though we were both worried about the sudden change in plans, we were anxious to be able to begin exploring Lima. Our first stop was Norky’s, a nice yet relatively cheap restaurant where we ate our first meal consisting of chicken (little did we know that Peruvians love their chicken and that we would quickly become tired of eating it). Once the bill was paid, it was already 12 in the morning, yet we felt confident that we could find our hotel with the quick instructions our cab driver had left us… We found ourselves walking in circles for over an hour and ended up asking several locals for help. Even Google Maps failed us, leading us back and forth down the same street at least four times due to confusion over the direction of the compass. Ultimately, we gave up, flagged down a taxi, and when arriving at the hotel, gladly crawled into bed to call it a night.

Saturday consisted of getting to know our surroundings. Max, a member of Dios es Amor gave us a great tour of Miraflores and we quickly became experts on our surroundings (and more importantly, experts of how to get back to our hotel). We walked around Parque Kennedy, a local market, the beach, and a touristy shopping area. At nighttime, we headed to the ‘Centro de Lima’ and were pleasantly surprised by how different this district was. It became evident that each district has its own unique, yet charming style and feel. A successful first day to say the least, and we are eager to explore the many other parts of Lima in the next coming days!

Though I was sick with food poisoning the first time the GROW team went to Jose Galvez hospital in La Tablada, I was able to go back with everyone and spend the morning in the Tuberculosis ward. It was very interesting and eye-opening to meet some of the patients that come to Jose Galvez to receive their medicines for TB because most had come from distant parts of Peru. I talked to a young man named Ricardo who had come from a long way, from his rural village in the jungle all the way to Lima when he found out he was infected with TB. He told me about how TB awareness in rural Peru is not very high, and thus when his friend at work was infected he didn’t realize it could have possibly been TB until he was infected himself and diagnosed by a doctor after he coughed up blood.

TB treatment, while free at Jose Galvez, is highly expensive and this is why people travel to Lima from such remote parts of Peru. The treatment also can take up to two years, and while patients can work again after the first six months of treatment, not working for so long can be a challenge for many patients. In addition to many antibiotic pills, shots must also be injected as well as part of the treatment. A kind nurse working at the ward told me that many patients lose hope after infected with TB, thinking that they are going to die and that they really don’t have many options, even though they are already being treated. Such fatalism is a challenge for the medical staff, who want to provide healthcare for these patients, but wonder how they can raise awareness, given the fact that many patients don’t follow up with their treatments according to schedule.